
<script type='text/javascript' src='../wp-content/themes/theme1273/js/jquery-1.6.minf24c.js?ver=1.6'></script>
<script type='text/javascript' src='../wp-content/themes/theme1273/js/jquery.prettyPhoto19ce.js?ver=3.0.3'></script>
<script type='text/javascript' src='../wp-content/themes/theme1273/js/jquery.loader5152.js?ver=1.0'></script>

<style type="text/css">
table {
	font-family: Tahoma, Verdana, Arial;
	color:#FFF;
	font-size:12px;
}
</style>

<form name="payform" action="addMoney.php" method="get">
    <table>
	    <tr>
        <td>Charge Amount: </td> <td colspan="2"><input type="text" name="importo" id="importovalue" value=""></td>
        </tr>
    	<tr>
        <td>Card Number: </td> <td><input type="text" name="annoscadenza" id="annoscadenzavalue" value=""></td>
        <td>Expire:
             
            <select name="mesescadenza" id="mesescadenzavalue" class="select_month">
              <option value="0" selected >Month</option>
	<option value="01"  >January</option>
	<option value="02"  >February</option>
	<option value="03"  >March</option>
	<option value="04"  >April</option>
	<option value="05"  >May</option>
	<option value="06"  >June</option>
	<option value="07"  >July</option>
	<option value="08"  >August</option>
	<option value="09"  >September</option>
	<option value="10"  >October</option>
	<option value="11"  >November</option>
	<option value="12"  >Dicember</option>
</select>
            <select name="annoscadenza2" id="annoscadenza" class="selectXSmall">
              <option value="0" selected >Year</option>
              <option value="2011"  >2011</option>
              <option value="2012"  >2012</option>
              <option value="2013"  >2013</option>
              <option value="2014"  >2014</option>
              <option value="2015"  >2015</option>
              <option value="2016"  >2016</option>
              <option value="2017"  >2017</option>
              <option value="2018"  >2018</option>
              <option value="2019"  >2019</option>
              <option value="2020"  >2020</option>
              <option value="2021"  >2021</option>
              <option value="2022"  >2022</option>
              <option value="2023"  >2023</option>
              <option value="2024"  >2024</option>
              <option value="2025"  >2025</option>
              <option value="2026"  >2026</option>
              <option value="2027"  >2027</option>
              <option value="2028"  >2028</option>
              <option value="2029"  >2029</option>
              <option value="2030"  >2030</option>
              <option value="2031"  >2031</option>
          </select></td>
        </tr>
        <td></td>
        <tr> 
        <td >Security Number</td> <td colspan="2"> <input type="text" name"numsic" id="numsecvalue" value=""> <img src="imagePay/infoOut.png" onMouseOver="this.src = 'imagePay/infoOut.png'" onMouseOut="this.src = 'imagePay/infoOut.png'" style="cursor:pointer" onClick="window.open('numsicpopup.html', 'Informazioni carta di credito', 'width=420,height=570,resizable=no');"></td>
        </tr>
        <tr>
        </tr>
        <tr>
        <td > First and Last Name </td> <td colspan="2"> <input type="text" name"nomecognomecarta" id="nomecognomecartavalue" value="" style="width:400px">  </td>
        </tr>
        <tr>
          <td height="28" colspan="3" style="text-align:justify">
        The First and Last Name must be entered as shown on the credit card used and <strong>must match</strong> registration</td>
        </tr>
        <tr><td colspan="3"> <hr color="#999999"></td></tr>
        <tr>
        	<td colspan="3" style="text-align:right"><img style="cursor:pointer;" src="../wp-content/themes/theme1273/images/confirm.png" onclick="validate ();"/></td>
        </tr>
    </table>
</form>

<script type="text/javascript">
	function confirmPay(){
		//tutti i campi si 
		document.payform.submit();
	}
	
	function validate () {
		
		if ( !( /^[0-9]*(\.[0-9]+)?$/.test ( $ ( '#importovalue' ).val () ) ) || !( $ ( '#importovalue' ).val ().length > 0 ) ) { 
			alert ( "Warning! The amount must be numeric" );
			return;
		}
		
		if ( !( /^[0-9]{16}$/.test ( $ ( '#annoscadenzavalue' ).val () ) ) || !( $ ( '#annoscadenzavalue' ).val ().length > 0 ) ) { 
			alert ( "Warning! The code must be numeric and/or sixteen digits" );
			return;
		}
		
		if ( $ ( "#mesescadenzavalue" ).val () == 0 ) {
			alert ( "Warning! Select month" );
			return;
		}
		
		if ( $ ( "#annoscadenza" ).val () == 0 ) {
			alert ( "Warning! Select year" );
			return;
		}
		
		if ( !( /^[0-9]{3}$/.test ( $ ( '#numsecvalue' ).val () ) ) || !( $ ( '#numsecvalue' ).val ().length > 0 ) ) { 
			alert ( "Warning! The security numbert must be numeric and/or three digits" );
			return;
		}
		
		if ( !( $ ( '#nomecognomecartavalue' ).val ().length > 0 ) ) { 
			alert ( "Warning! You must enter a surname and / or name" );
			return;
		}
		
		confirmPay ();
	}
</script>